Archives of Women's Mental Health

, Volume 22, Issue 1, pp 85–91 | Cite as

Impact of maternal depression on perinatal outcomes in hospitalized women—a prospective study

  • Narkis HermonEmail author
  • Tamar Wainstock
  • Eyal Sheiner
  • Agneta Golan
  • Asnat Walfisch
Original Article


Scarce data exists regarding the prevalence of antenatal depression in hospitalized pregnant women, and its effect on perinatal outcome. We aimed to estimate the risk of maternal depression among women hospitalized in a high-risk pregnancy department, and to evaluate its potential association with adverse perinatal outcome. A depression screening self-questionnaire-based prospective study was performed, in which hospitalized pregnant women who screened positive for depression were compared to those who screened negative. The Edinburgh Postnatal Depression Scale (EPDS) was used for antenatal depression screening. Pregnancy course and perinatal outcome were compared between the groups. A multivariate logistic regression model was constructed to control for clinically relevant confounders. During the study period, 279 women met the inclusion criteria. Among them, 28.3% (n = 79) screened positive for depression (≥ 10 points on the EPDS). In the univariate analysis, a significantly higher incidence of preterm delivery (< 37 weeks), low birthweight (< 2500 g), low Apgar scores (at 1 and 5 min), and neonatal intensive care unit (NICU) admissions were noted among the screen positive group. In the multivariate regression model, controlled for maternal age, ethnicity, gestational diabetes mellitus, preeclampsia, past preterm delivery, and gestational age upon admission, maternal antenatal depression during hospitalization was noted as an independent risk factor for preterm delivery (adjusted OR 3.32, 95%CI 1.16–9.52, p = 0.026). Maternal antenatal depression during hospitalization is very common and appears to play a significant and independent role in the prediction of preterm delivery.


Antenatal depression High-risk pregnancy Screening EPDS 


Compliance with ethical standards

The study was approved by the local institutional ethical review board (SUMC IRB).

Conflict of interest

The authors report no conflict of interest. This study was conducted as part of the requirements for graduation from the Medical School of the Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.


  1. Abu-Ghanem S, Sheiner E, Sherf M, Wiznitzer A, Sergienko R, Shoham-Vardi I (2012) Lack of prenatal care in a traditional community: trends and perinatal outcomes. Arch Gynecol Obstet 285(5):1237–1242CrossRefGoogle Scholar
  2. Adouard F, Glangeaud-Freudenthal N, Golse B (2005) Validation of the Edinburgh 7postnatal depression scale (EPDS) in a sample of women with high-risk pregnancies in France. Arch Womens Ment Health 8(2):89–95CrossRefGoogle Scholar
  3. Alder J, Fink N, Urech C, Hösli I, Bitzer J (2011) Identification of antenatal depression in obstetric care. Arch Gynecol Obstet 284(6):1403–1409CrossRefGoogle Scholar
  4. Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2004) Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol 104(3):467–476CrossRefGoogle Scholar
  5. Bergink V, Kooistra L, Lambregtse-van den Berg MP, Wijnen H, Bunevicius R, van Baar A et al (2011) Validation of the Edinburgh Depression Scale during pregnancy. J Psychosom Res 70(4):385–389CrossRefGoogle Scholar
  6. Biaggi A, Conroy S, Pawlby S, Pariante CM (2016) Identifying the women at risk of antenatal anxiety and depression: a systematic review. J Affect Disord 191:62–77CrossRefGoogle Scholar
  7. Brandon AR, Trivedi MH, Hynan LS, Miltenberger PD, Labat DB, Rifkin JB, Stringer CA (2008) Prenatal depression in women hospitalized for obstetric risk. J Clin Psychiatry 69(4):635–643CrossRefGoogle Scholar
  8. Brittain K, Myer L, Koen N, Koopowitz S, Donald KA, Barnett W, Zar HJ, Stein DJ (2015) Risk factors for antenatal depression and associations with infant birth outcomes: results from a South African Birth Cohort Study. Paediatr Perinat Epidemiol 29(6):505–514CrossRefGoogle Scholar
  9. Byatt N, Hicks-Courant K, Davidson A, Levesque R, Mick E, Allison J, Moore Simas TA (2014) Depression and anxiety among high-risk obstetric inpatients. Gen Hosp Psychiatry 36(6):644–649CrossRefGoogle Scholar
  10. Chung TK, Lau TK, Yip AS, Chiu HF, Lee DT (2001) Antepartum depressive symptomatology is associated with adverse obstetric and neonatal outcomes. Psychosom Med 63(5):830–834CrossRefGoogle Scholar
  11. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Br J Psychiatry 150:782–786CrossRefGoogle Scholar
  12. Cwikel J, Lev-Wiesel R, Al-Krenawi A (2003) The physical and psychosocial health of Bedouin Arab women of the Negev area of Israel: the impact of high fertility and pervasive domestic violence. Voilence Against Women 9(2):240–257CrossRefGoogle Scholar
  13. Dagklis T, Papazisis G, Tsakiridis I, Chouliara F, Mamopoulos A, Rousso D (2016) Prevalence of antenatal depression and associated factors among pregnant women hospitalized in a high-risk pregnancy unit in Greece. Soc Psychiatry Psychiatr Epidemiol 51(7):1025–1031CrossRefGoogle Scholar
  14. Dayan J, Creveuil C, Marks MN, Conroy S, Herlicoviez M, Dreyfus M, Tordjman S (2006) Prenatal depression, prenatal anxiety, and spontaneous preterm birth: a prospective cohort study among women with early and regular care. Psychosom Med 68(6):938–946CrossRefGoogle Scholar
  15. Glasser S, Stoski E, Kneler V, Magnezi R (2011) Postpartum depression among Israeli Bedouin women. Arch Womens Ment Health 14(3):203–208CrossRefGoogle Scholar
  16. Grigoriadis S, VonderPorten EH, Mamisashvili L, Tomlinson G, Dennis C, Koren G et al (2013) The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 74(4):e321–e341CrossRefGoogle Scholar
  17. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ (2010) A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry 67(10):1012–1024CrossRefGoogle Scholar
  18. Israeli Ministry of Health (2014) Procedure for detecting women at risk for antenatal and postpartum depression. Available at: Accessed 02 Jan 2018
  19. Lau Y, Wong DFK, Chan KS (2010) The utility of screening for perinatal depression in the second trimester among Chinese: a three-wave prospective longitudinal study. Arch Womens Ment Health 13(2):153–164CrossRefGoogle Scholar
  20. Miller L, Shade M, Vasireddy V (2009) Beyond screening: assessment of perinatal depression in a perinatal care setting. Arch Womens Ment Health 12(5):329–334CrossRefGoogle Scholar
  21. Navaratne P, Foo XY, Kumar S (2016) Impact of a high Edinburgh Postnatal Depression Scale score on obstetric and perinatal outcomes. Sci Rep 6:33544CrossRefGoogle Scholar
  22. Pavlov M, Steiner N, Kessous R, Weintraub AY, Sheiner E (2014) Obstetric and neonatal outcome in patients with anxiety disorders. J Matern Fetal Neonatal Med 27(13):1339–1342CrossRefGoogle Scholar
  23. Rahman A, Bunn J, Lovel H, Creed F (2007) Association between antenatal depression and low birthweight in a developing country. Acta Psychiatr Scand 115(6):481–486CrossRefGoogle Scholar
  24. Sharma P, Avasthi A, Chakrabarti S, Varma S (2002) Depression among hospitalised medically ill patients: a two-stage screening study. J Affect Disord 70(2):205–209CrossRefGoogle Scholar
  25. Sheiner E, Shoham-Vardi I, Weitzman D, Gohar J, Carmi R (1998) Decisions regarding pregnancy termination among Bedouin couples referred to third level ultrasound clinic. Eur J Obstet Gynecol Reprod Biol 76(2):141–146CrossRefGoogle Scholar
  26. Walfisch A (2012) Maternal depression and perception of teratogenicity. J Popul Ther Clin Pharmacol 19(3):e376–e379PubMedGoogle Scholar
  27. Yedid Sion M, Harlev A, Weintraub AY, Sergienko R, Sheiner E (2016) Is antenatal depression associated with adverse obstetric and perinatal outcomes? J Matern Fetal Neonatal Med 29(6):863–867CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Narkis Hermon
    • 1
    Email author
  • Tamar Wainstock
    • 2
  • Eyal Sheiner
    • 3
  • Agneta Golan
    • 4
  • Asnat Walfisch
    • 3
  1. 1.Joyce and Irving Goldman Medical School, Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael
  2. 2.The Department of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael
  3. 3.Department of Obstetrics and GynecologySoroka University Medical Center, Ben-Gurion University of the NegevBeer-ShevaIsrael
  4. 4.Neonatal Intensive Care UnitSoroka University Medical Center, Ben-Gurion University of the NegevBeer-ShevaIsrael

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